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Monday, December 05, 2011

nurses are not superheroes

Medicine is changing. Hospitals are changing. It has become about business, money. There is no choice in the matter. Its reality.

There is so much emphasis on patient care satisfaction. On standardization of everything across the corporation. More and more complex procedures and polciies are evolving. Lost in all of this is the nurse.

I really wonder if there are other jobs that change as rapidly as nursing. It is constant, overwhelming change. Change it is hard to keep up with. I've given up trying to keep up with it. I try to remember the important stuff and ignore the rest.

Nursing has become a complex job with increasing complex technology and procedures. Nurses handle patients with LVADs, ECMO, hypothermia treatment to name a few. People are being kept alive today that never would have had a chance even ten years ago. Who is keeping them alive? Nurses.

With the emphasis on patient satisfaction, we are expected to handle a diversity of patients with all their perisonality disorders and neuroses with a smile on our face. When it comes down to it, we are expected to be superhuman.

With all the rapid change, emphasis on the bottom line, patient satisfaction - no attention is given to employee satisfaction. We are just expected to grind it out and be happy about it. The thing that is missing in all of this change in medicine is the lack of caring about the employee. What all of these hospitals fail to understand is that if the employees aren't happy, the patients won't be happy. The lack of understanding of that will be their downfall.

7 comments:

One thing I like about my small, rural podunk hospital in Montana regarding employee satisfaction is they talk to the employees at least every 3 months or so individually. This is required. They ask you what is working well, what needs improvement, what questions you have, etc.

When your suggestion is acted upon, you end up in the newsletter. Thanks to Nurse K for suggesting an add-on to our existing technology for ___ which is coming in January.

When another employee in mentions you as someone good to work with, you end up in the newsletter. Same if a patient mentions you.

When I brought up an employee that was hostile towards me, my boss started working on that right away.

Of course, you can't be a hospital that has 60 direct reports per manager like my old hospital and expect them to do anything like employee chats, so administration really has to be on board with this kind of stuff.

My little suburban hospital is the cash cow for our local chain- geared towards elective surgery and "amazing birth experiences....". Our knife n gun club sister hospital is chugging along, SSDD. We are up a creek without a paddle. We've lost our insured population, our volumes are down, we are getting shifts cancelled at least weekly. It's scary and we have bills to pay. I will give the place credit though- a doc went to the CEO one day and said "the nurses are scared about this.". The CEO had 3 meetings with nurses within 4 hours to discuss it, and to tell us what was in the works to fix it. It's still scary but they care. I worked the day after thanksgiving- the CEO showed up unannounced and made rounds. Could be better, but could be worse.

"The lack of understanding of that will be their downfall." You have spotted the problem. I suggest you bring it to administration's attention.Specify what the nurses are not happy about, and indicate if the problem(s) is not solved there will be a nurse shortage.

Great points made here. As a nurse I know we are not superhuman but if feel like at times we are expected to be. I like to also say it seems that medical professionals are always "guilty until proven innocent" and I get we have very high standards to look up to as compared to the local fast food employee. Patient satisfaction is always a must, of course we don't want to employment policies that decrease patient satisfaction, but it seems rare that policy makers truly care about the increased strain on the nurse. It seems too often that people want to blame the medical professionals for dissatisfaction but at what point can we blame the system or even the patient.

All to often (in the ED level 1 public hospital) I have seen patients get very angry at the time they have spent waiting or once they get a bed the time spent in it. I personally have never had a Formal complaint about timeliness, but have heard complaints such as "the nurse didn't do anything for hours, or he didn't do this or that" So solutions I see to this are, A. be more available to the patient and such or B. Educate they patient and leave some responsibilty on them.

With A: I'm sure we all wish we could be more availible for our patients but on a night with 20 trauma bay patients and you are on the team, it's tough to be there all the time.

B: I've always thought that so many situations can be solved with a little education. Maybe instead of putting Judge Judy on the tv in the waiting room there should be a short clip explaining how an ER works. Explain how the triage levels work, explain that there are also patient coming in via EMS. Obviously this could be expanded. Next, once the patient had a bed and the chris complaint has been assessed, explain what is going to happen next. For example: a patient comes in with chest pain, obviously the first thought is heart attack being that this is one of the more serious issues associated with a heart attack. Explain that you have to take certain labs hours apart like triponin. This way they get the general idea that it isn't the nurse or MD that they are waiting on but that it is the set standard length of time between lab draws. I have done this for a long time even though it isn't policy, and the outcomes have been great. I have had far less "nagging" and "complaining" when the patient and family members understand the process. I think if ED adopted a process of the RN/MD briefly explaining what will be done, with a very basic pamflit pertaining to the chief complaint there would be increased employee moral as well as increased patient satisfaction.

To me doing this you would eliminate nagging such as "how much longer till I get a bed", "what's taking soo long", the list goes on. Well I'm done ranting, hope this is close to staying on topic

regarding Anonymous "Explain how the triage levels work" in video and paper pamphlets.I think that's a good idea for the upset ER patient.Those patients that would not read it and throw the pamphlet on the ground, could be judged irrational or "mentally ill".Or they can't read.

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